Nervous
How would the nurse instruct a patient with Parkinson disease to improve activity level? A. To sit in hard chair with arms for posture control B. To walk with hands clasped behind back to help balance C. To use a soft mattress to relax the spine D. To walk with a shuffling gait to avoid tripping
B. To walk with hands clasped behind back to help balance
What is the basic problem that prompts most of the early signs of Alzheimer disease? A. Problems with words in speaking B. Misplacing things C. Memory loss that disrupts daily life D. Changes in mood
C. Memory loss that disrupts daily life
The 85 year old patient diagnosed with stroke is complaining of severe headache. Which intervention should the nurse implement first? A. administer a nonnarcotic analgesic B. start an intravenous infusion with D5W at 100 ml/hr C. prepare for a STAT MRI D. complete a neurological assessment
D. complete a neurological assessment
An 83-year-old patient has had a stroke. He is right-handed and has a history of hypertension and "little" strokes. He presents with right hemiplegia. To afford him the best visual field, the nurse should approach him: A. from the center. B. from the right side. C. from either side. D. from the left side.
D. from the left side.
A family member of a patient who has just suffered a tonic-clonic seizure is concerned about the patient's deep sleep. What is this behavior called? A. Postictal period B. Neural recovery period C. Convalescent period D. Sombulant period
Postictal period
What should the nurse do when the child arrives on the floor with the diagnosis of bacterial meningitis? A. Inquire about drug allergy B. Place the child in respiratory isolation C. Arrange for humidified oxygen per mask D. Hold NPO until orders arrive
B. Place the child in respiratory isolation
Why are the drugs neostigmine (Prostigmin) and pyridostigmine (Mestinon) helpful to the person with myasthenia gravis?' A. Improves speech B. Promotes nerve impulse transmission C. Improves visual disturbances D. Reduces pain
B. Promotes nerve impulse transmission
The nurse is caring for the client with encephalitis. Which intervention should the nurse implement first if the client is experiencing a complication? A. examine pupil reactions to light B. monitor vital signs every shift C. observe for seizure activity D. monitor vital signs every shift
B. monitor vital signs every shift
What are the two divisions of the nervous system? A. Medulla oblongata and the diencephalon B. Cerebellum and the brainstem C. Somatic and the autonomic D. Central and the peripheral
D. Central and the peripheral
What are the effects of normal aging on the nervous system? (Select all that apply.) A. Lipofuscin B. Loss of neurons C. Decrease in oxygen use D. Reduction of cerebral blood flow E. Small vessel occlusion F. Calcification of cerebrum
A. Lipofuscin B. Loss of neurons D. Reduction of cerebral blood flow
The newly admitted patient to the emergency room after a motorcycle accident has serosanguineous drainage coming from the nose. What is the most appropriate nursing response to this assessment? A. Cleanse nose with a soft cotton-tipped swab B. Ask patient to blow his nose C. Gently suction the nasal cavity D. Gently wipe nose with absorbent gauze
D. Gently wipe nose with absorbent gauze
A frantic family member is distressed about the flaccid paralysis of her son following a spinal cord injury several hours ago. What does the nurse know about this condition? A. It will progress up the cord to cause seizures. B. It is an ominous indicator of permanent paralysis. C. It degenerates into a spastic paralysis. D. It is possibly a temporary condition and will clear.
D. It is possibly a temporary condition and will clear.
What is the purpose of a "drug holiday" in the treatment of Parkinson disease? A. Reduce the extrapyramidal symptoms B. Change all drugs C. Allow the natural dopamine levels to rise D. Restart drugs at a lower dosage with favorable results
D. Restart drugs at a lower dosage with favorable results
What Glasgow Coma Scale rating would a patient receive who opens the eyes spontaneously, but has incomprehensible speech and obeys commands for movement? A. 12 B. 8 C. 10 D. 11
A. 12
Which foods should the person who suffers from migraine headaches avoid? (Select all that apply.) A. Caffeine B. Pears C. Beef D. Marinated foods E. Yogurt F. Milk
A. Caffeine D. Marinated foods E. Yogurt
What is the cardinal sign of increased intracranial pressure in a brain injured patient? A. Decrease in the level of consciousness B. Vomiting C. Pupil changes D. Ipsilateral paralysis
A. Decrease in the level of consciousness
What is the first sign of Bell's palsy? A. Inability to wrinkle forehead and pucker lips on affected side B. Excessive mucus running from nostril on affected side C. Excessive salivation on the affected side D. Sudden pain in nostril on affected side
A. Inability to wrinkle forehead and pucker lips on affected side
A patient is in which stage of Alzheimer disease when she demonstrates "sundowning"? A. Second stage B. Final stage C. Third stage D. Early stage
A. Second stage
A patient has recently suffered a stroke with left-sided weakness and has problems with choking, especially when drinking thin liquids. What nursing interventions would be most helpful in assisting this patient to swallow safely? A. Tuck chin when swallowing B. Turn head to the left C. Take a sip of liquid with each bite D. Use a straw
A. Tuck chin when swallowing
What is the reticular activating system (RAS) essential to? (Select all that apply.) A. Wakefulness B. Speech C. Memory D. Attention E. Concentration F. Introspection
A. Wakefulness D. Attention E. Concentration F. Introspection
A client diagnosed with a closed head injury is admitted to rehabilitation. Which medication order would the nurse question? A. an intravenous osmotic diuretic B. an oral proton pump inhibitor C. a subcutaneous anticoagulant D. an oral anticonvulsant
A. an intravenous osmotic diuretic
The client diagnosed with atrial fibrillation has experienced a transient ischemic attack (TIA). Which medication would the nurse anticipate being ordered for the client on discharge? A. an oral anticoagulant medication B. a beta blocker medication C. an anti-hyperuricemic medication D. a thrombolytic medication
A. an oral anticoagulant medication
The nurse is aware that the characteristic gait of the person with Parkinson disease is a propulsive gait, which causes the patient to: A. shuffle with arms flexed. B. stagger and need support of a walker. C. take small steps balanced on the toes. D. fall over to one wide when walking.
A. shuffle with arms flexed.
What does the nurse know about the stroke patient who has expressive aphasia? A. Has difficulty comprehending spoken and written communication B. Cannot make any vocal sounds C. Has total loss and comprehension of language D. Cannot make any vocal sounds
B. Cannot make any vocal sounds
Which of the following techniques are necessary for safely feeding a hemiplegic patient? (Select all that apply.) A. Taking the patient's dentures out to prevent choking B. Adding a thickening agent to liquids C. Offering small bites of food D. Checking the affected side of mouth for food accumulation E. Mixing liquids and solid foods together F. Elevating the patient to no more than 30 degrees
B. Adding a thickening agent to liquids C. Offering small bites of food D. Checking the affected side of mouth for food accumulation
The newly admitted patient to the emergency room 30 minutes ago after a fall off a ladder has gradually decreased in consciousness and has slowly reacting pupils, a widening pulse pressure, and verbal responses that are slow and unintelligible. What is the most appropriate position for the patient? A. Head raised slightly with hips flexed B. Neck placed in a neutral position C. Supine in gravity neutral position D. Turn on right side with head elevated
B. Neck placed in a neutral position
The nurse and an unlicensed assistive personnel (UAP) are caring for a client with right-sided paralysis. Which action by the UAP requires the nurse to intervene? A. The assistant places a gait belt around the client's waist prior to ambulating B. The assistant places a hand under the client's right axilla to move up in bed C. The assistant places the client on the back W/ the client's head to the side D. The assistant praises the client for attempting to perform ADLs independently
B. The assistant places a hand under the client's right axilla to move up in bed
What is the cranial nerve that supplies most of the organs in the thoracic and abdominal cavities and also carries motor fibers to glands that produce digestive juices and other secretions? A. Abducens nerve B. Vagus nerve C. Visceral sensory nerve D. Somatic motor nerve
B. Vagus nerve
The unlicensed assistive personnel is attempting to put an oral airway in the mouth of a client having a tonic clonic seizure. Which action should the primary nurse take? A. help the UAP to insert the oral airway B. tell the UAP to stop trying to insert anything in the mouth C. take no action because the UAP is handling the situation D. notify the charge nurse of the situation immediately
B. tell the UAP to stop trying to insert anything in the mouth
Which question is likely to elicit the most valid response from the patient who is being interviewed about a neurologic problem? A. "Do you have any sensations of pins and needles in your feet?" B. "Do you ever have any nausea or dizziness?" C. "Can you describe the sensations you are having?" D. "Does the pain radiate from your back into your legs?"
C. "Can you describe the sensations you are having?
How would a nurse record the behavior when a patient with Alzheimer disease attempts to eat using a napkin rather than a fork? A. Apraxia B. Aphasia C. Agnosia D. Dysphagia
C. Agnosia
The nurse assures an anxious family member of a 92-year-old patient who is demonstrating signs of dementia that many causes of dementia are reversible and preventable. What is one example? A. Alzheimer disease B. Diabetes C. Hypotension D. Parkinson disease
C. Hypotension
What are the three signs of Cushing response? (Select all that apply.) A. Increased pulse rate B. Increased blood pressure C. Increased systolic blood pressure D. Uncontrolled thermoregulation E. Widened pulse pressure F. Bradycardia
C. Increased systolic blood pressure E. Widened pulse pressure F. Bradycardia
What is the nurse aware of when assessing a person with a craniocerebral injury? A. Open injuries are always more serious than closed injuries B. Trauma to the frontal lobe is more significant than to any other area C. Signs and symptoms may not occur until several days after the trauma D. Most injuries of this type are irreversible
C. Signs and symptoms may not occur until several days after the trauma
A patient with a spinal cord injury at T1 complains of stuffiness of the nose and a headache. The nurse notes a flushing of the neck and "goose flesh." What should be the primary nursing intervention based on these assessments? A. Place patient in flat position and check temperature B. Administer oxygen and check oxygen saturation C. Sit upright and check blood pressure D. Place on side and check for leg swelling
C. Sit upright and check blood pressure
The nurse is caring for a home health patient who had a spinal cord injury at C5 three years ago. The nurse bases the plan of care on the knowledge that the patient will be able to: A. sit with good balance. B. stand erect with full leg braces. C. feed self with setup and adaptive equipment. D. transfer self to wheelchair.
C. feed self with setup and adaptive equipment.
The nurse is aware that the drug t-PA (Activase), a tissue plasminogen activator, must be given in____hours of the onset of symptoms to have maximum benefit. A. 4 hours B. 6 hours C. 3 hours D. 8 hours
D. 3 hours
The son of a client diagnosed with ALS asks the nurse, Is there any chance that I could get this disease? Which statement by the nurse would be most appropriate? A. No, this disease is not genetic or contagious B. If you are exposed to the same virus, you may get the disease C. It must be scary to think you might get this disease D. ALS does have a genetic factor and runs in families
D. ALS does have a genetic factor and runs in families
A 78 year old client is admitted to the emergency department with numbness and weakness of the left arm and slurred speech. Which nursing intervention is priority? A. notify the speech pathologist for an emergency consult B. prepare to administer recombinant tissue plasminogen activator C. schedule for a stat computed tomography (CT) scan of the head D. discuss the precipitating factors that caused the symptoms
B. prepare to administer recombinant tissue plasminogen activator
The client diagnosed with a brain tumor is admitted to the intensive care unit with decorticate posture. Which indicates that the client's condition is becoming worse? A. the client has purposeful movement with painful stimuli B. the client has become flaccid and does not respond to stimuli C. the client has assumed adduction of the upper extremities D. the client is aimlessly thrashing in the bed
B. the client has become flaccid and does not respond to stimuli
The 29 year old client is admitted to the medical floor diagnosed with meningitis. Which assessment by the nurse has priority? A. Assess lung sounds B. Assess the apical pulse C. Assess the six cardinal fields of gaze D. Assess level of consciousness
D. Assess level of consciousness
A patient, age 45, is to have a myelogram to confirm the presence of a herniated intervertebral disk. Which nursing action should be planned with respect to this diagnostic test? A. Ambulate the patient when returned to the room after the test. B. Keep NPO for 6 to 8 hours after the test. C. Use heated blanket to keep patient warm after procedure. D. Obtain an allergy history before the test.
D. Obtain an allergy history before the test.
As the result of a stroke, a patient has difficulty discerning the position of his body without looking at it. In the nurse's documentation, which would best describe the patient's inability to assess spatial position of his body? A. Agnosia B. Apraxia C. Sensation D. Proprioception
D. Proprioception
Which symptom is specific to migraine headaches? A. They become worse in the evening B. Tachycardia C. They involve the entire head D. They are preceded by an aura
D. They are preceded by an aura
The public health nurse is giving a lecture on potential outbreaks of infectious meningitis. Which population is most at risk for an outbreak? A. employees in a high rise office building B. clients recently discharged from the hospital C. individuals who visit a third world country D. residents of a college dormitory
D. residents of a college dormitory
Following a myelogram the nurse should include in the post procedure care assessment for: A. urine retention. B. slurred speech. C. elevation of blood pressure. D. sensation in lower extremities.
D. sensation in lower extremities.
The client is in the terminal stage of ALS. Which intervention should the nurse implement? A. encourage a low protein, mechanical soft diet B. Perform passive ROM every two hours C. maintain a negative nitrogen balance D. turn the client and have him cough and deep breathe every shift
B. Perform passive ROM every two hours
Why is the patient with suspected Guillain-Barre Syndrome (GBS) hospitalized immediately? A. The brain may swell quickly causing seizures B. The disease can rapidly progress into respiratory failure C. The infection needs to be treated with IV antibiotics to prevent paralysis D. IV hydration is needed to prevent possible fatal hypotension
B. The disease can rapidly progress into respiratory failure
Which assessment data would indicate to the nurse that the client would be at risk for a hemorrhagic stroke? A. a right sided carotid bruit B. the presence of bronchogenic carcinoma C. a blood glucose level of 480 mg/dl D. a blood pressure of 220/120 mm Hg
D. a blood pressure of 220/120 mm Hg
The nurse is assessing a client admitted with encephalitis. Which data require immediate nursing intervention? A. has a recurrent temperature of 100.6 F B. Has a decreased complaint of headache C. Has bilateral facial palsies D. comments that the meal has no taste
D. comments that the meal has no taste